ICD-10-CM 2019: Know the Documentation You’ll Need for New Gallbladder and Cholangitis Codes

Thu, Aug 16, 2018


If you code cholecystitis or cholangitis, you’ll want to know these new codes when ICD-10-CM 2019 kicks in on Oct. 1, 2018. Check out the helpful hints below to be sure you know how to apply the codes from the get-go.

Watch ‘Code First’ Note With New Cholecystitis Codes

ICD-10-CM 2019 adds new subcategory K82.A- (Disorders of gallbladder in diseases classified elsewhere).

There are two complete, reportable codes in the subcategory:

  • K82.A1 (Gangrene of gallbladder in cholecystitis)
  • K82.A2 (Perforation of gallbladder in cholecystitis).

Code …

Continue reading...

Modifier 58 or 78? Master These Confusing Modifiers

Mon, Aug 13, 2018


choosing between modifier 58 and modifier 78 for procedures

Knowing when to use modifiers 58 and 78 isn’t easy. Base your choices on this straight-from-Medicare guidance to help ensure cleaner claims.

Make Modifier 58 Your Choice for Anticipated Procedures

Modifier 58 (Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period) is the focus of Medicare Claims Processing Manual (MCPM), chapter 12, section 40.2.A.6.

Here are the reasons that the MCPM gives for why a physician may use …

Continue reading...

Crash Course: Compare ICD-10-CM 2019 Official Guidelines for Post-Op Sepsis to 2018 Rules

Thu, Aug 9, 2018


The ICD-10-CM 2019 Official Guidelines are out and offer more details on how to use new codes for sepsis following a procedure. Take a look at what’s new and get a handle on how to sequence these codes.

Remember These New Codes to Improve Sepsis Coding

ICD-10-CM 2019 includes these two new codes with instructional notes:

  • Obstetrical: O86.04 (Sepsis following an obstetrical procedure)
    • Use additional code to identify the sepsis
  • Other procedures: T81.44X- (Sepsis following a procedure)
    • Use additional code to identify the sepsis.

These codes are part of an expansion of Continue reading...

Top Nuances to Know for the Medicare Card MBI Roll-Out

Mon, Aug 6, 2018


Check your patients' Medicare cards for MBIs

Medicare began mailing out new cards in April 2018 to meet the deadline of replacing Social Security numbers/Health Insurance Claim Numbers (HICNs) with Medicare Beneficiary Identifiers (MBIs) by April 2019. Here are some tips you may have missed to help you with the transition.

Don’t Use the Dashes!

On the new Medicare cards and in the training materials about the new MBI from Medicare, you’ll see the MBI formatted like this: 1EG4-TE5-MK73.

Important: Do not enter the dashes (hyphens) or any spaces as part of the number. In …

Continue reading...

Hot Topic: Get the Scoop on Proposed MPFS 2019 Changes to E/M Coding and Payment

Fri, Aug 3, 2018


MPFS 2019 proposed rule

The 2019 proposed Medicare Physician Fee Schedule (MPFS) includes some major potential changes to E/M coding and payment in its 665 pages. Major. Here are the highlights. Just remember that what’s below is proposed and may change before the final rule is implemented.

Here’s the Big Payment News About Levels 2-5

Let’s get right to it. CMS wants to create a single set of RVUs for 99202-99205 (new patient office/outpatient E/M) and another single …

Continue reading...

ICD-10-CM 2019: Here’s What You Need to Know About Appendicitis, Screenings, and Blepharitis

Mon, Jul 30, 2018


ICD-10-CM 2019 implementation is just a couple of months away. The effective date, Oct. 1, 2018, is coming our way fast. Here are some interesting tidbits from our TCI Coding Alerts on the 2019 diagnosis code updates for appendicitis, screenings, and eye care to help you prepare.

Bonus tip: The 2019 ICD-10-CM Official Guidelines for Coding and Reporting are now available on the CDC site. Updates include the new rule allowing you to report …

Continue reading...

Did You Know? AHA Says Nonphysician Documentation Supports Z55-Z65

Thu, Jul 26, 2018


documentation of social determinants for ICD-10 coding

Reporting ICD-10-CM social information codes (Z55-Z65) based on documentation from nonphysicians is OK, according to official guidelines from the AHA. Before you change your approach to coding, here are the facts.

Locate the Original Coding Clinic® Q&A

In early 2018, AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS (vol. 5, no. 1) published an answer to the question of whether you may use nonphysician documentation to assign codes that give information about social determinants of health. The example given was Z55-Z65 (Persons with potential health hazards related to socioeconomic and …

Continue reading...

3 Things to Know About Advanced Practice Providers in Your Practice

Fri, Jul 20, 2018


Advanced practice providers (APPs), sometimes known as non-physician practitioners (NPPs), are essential members of the healthcare team and serve a lot of roles. But, of course, “essential” doesn’t mean they’re always easy to code for. Make sure you keep these top pointers in mind when you’re completing claims for APPs, such as physician assistants, certified registered nurse anesthetists, and others.

1. Report APP Services Incident to a Physician’s Services for Higher Pay

When you’re talking about Medicare and payers that follow Medicare rules, you can expect APP services reported incident to a physician’s services generally to bring in 100 percent reimbursement. When reporting incident-to services, you bill using the supervising physician’s NPI rather than the APP’s NPI.

Continue reading...

Make Heart Failure Coding a Cinch With These Documentation Tips

Wed, Jul 18, 2018


ICD-10-CM coding for heart failure

Cardiology got off fairly light when it comes to 2019 ICD-10-CM changes, so that means you can devote some extra time and energy to refreshing your skills for your top diagnoses, like heart failure. One of the biggest problems experts report seeing in heart failure coding is that documentation supports coding only unspecified heart failure. Let’s look at the terms that will help lead to more specific codes for your acquired heart failure cases.

Zip to the Correct Heart Failure Code …

Continue reading...

Will You Ace This Gynecology Cervical-Health Coding Quiz?

Mon, Jul 16, 2018


Knowing uterine and cervical anatomy, and the difference between conization and biopsy will go a long way toward helping you with loop electrode excision procedure (LEEP) claims and other gynecology claims. This quiz helps give you a check up on terms and procedures.

Read the Questions Here

You’ve got two options for this quiz. If you want a harder version, read the questions in this section, and write down your answers. Don’t look at the next section, “Helpful Hint Option: Choose From These Possible Answers.” Then check your answers at the end.

If you want to choose from …

Continue reading...
Older Entries